Individual provider Active NPI

Elizabeth Rodriguez

  • Occupational Therapist
  • Tonasket, WA
National Provider Identifier
1629647060
Registry record updated Jan 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OT61193884 Issued in WA
Practice address
203 S Western Ave
Tonasket, WA 98855-8803
Phone
(509) 486-3114
NPI assigned
Jun 21, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 22, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X
Occupational Therapist 225X00000X OT61193884 WA Primary

Addresses

Primary practice location

203 S Western Ave
Tonasket, WA 98855-8803

Mailing address

203 S. Western Ave
C/O: Credentialing
Tonasket, WA 98855-8803
Phone (509) 486-3144

Other practice location 1

1706 Pickens Loop
Yakima, WA 98908-2050
Phone (509) 985-9518

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240502000227 WA Practitioner - Occupational Therapist in Private Practice 3870933237 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OT61193884WAMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Okanogan County Public Hospital Dist No 4 CurrentSince Feb 17, 2024 Accepting new patients
Okanogan County Public Hospital Dist No 4 Current Accepting new patients
Okanogan County Public Hospital Dist No 4 Current Accepting new patients
Okanogan County Public Hospital Dist No 4 Current Accepting new patients

Locations

203 S Western Ave
Tonasket, WA 98855
Phone (509) 486-2151

126 S Whitcomb Ave
Tonasket, WA 98855
Phone (509) 486-2151

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1624233600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705881600000",
    "number": "1629647060",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "203 S. WESTERN AVE",
            "address_2": "C/O: CREDENTIALING",
            "city": "TONASKET",
            "state": "WA",
            "postal_code": "988558803",
            "telephone_number": "509-486-3144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "203 S WESTERN AVE",
            "city": "TONASKET",
            "state": "WA",
            "postal_code": "988558803",
            "telephone_number": "509-486-3114"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1706 Pickens Loop",
            "address_purpose": "LOCATION",
            "city": "Yakima",
            "state": "WA",
            "postal_code": "989082050",
            "country_code": "US",
            "telephone_number": "509-985-9518",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "ELIZABETH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-21",
        "last_updated": "2024-01-22",
        "certification_date": "2024-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "WA",
            "license": "OT61193884",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tonasket, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.